Increasing trust and vaccine uptake: Offering invitational rhetoric as an alternative to persuasion in pediatric visits with vaccine-hesitant parents (VHPs)

Abstract

Healthcare professionals are increasingly concerned about vaccine hesitancy, an exigency the World Health Organization named one of the ten threats to global health, even before the COVID-19 pandemic. Traditional rhetorical strategies (e.g., persuasion) remain the default to help increase vaccine uptake, despite mounting evidence such techniques may not improve uptake and could alienate families. We offer invitational rhetoric—in which people honor opposing viewpoints rather than trying to change behavior—as an alternative to improve trust and childhood vaccine uptake. We conducted a six-month, mixed methods case study of a small, urban, pediatric healthcare practice in the western United States we believed used invitational methods in discussions with vaccine-hesitant parents (VHPs). We administered pre- and post-visit surveys to families; audio recorded and transcribed their two-month well child checks (WCCs); and facilitated individual interviews with the providers. We analyzed the data looking for patterns in how providers and families use and view traditional persuasion as compared to invitational rhetoric and the effect each has on vaccine uptake, trust, and provider wellbeing. One hundred five (n = 105) families and six healthcare providers participated, with 35 families planning to receive fewer than the CDC-recommended number of vaccinations prior to their WCC. After their visit, however, 37% of VHPs increased their vaccine uptake compared to their pre-visit plans; 80% of VHPs selected top box scores for trust of their providers; and 85% of VHPs who chose to increase their vaccine uptake also selected top box trust scores. Our findings indicate invitational rhetoric may play a meaningful role in increasing vaccine uptake; sustaining or even improving a family’s trust in their provider; and positively impacting provider wellbeing. Further research is needed on the use of invitational rhetoric exclusively.